This remarkable book is dedicated to homeless people in New York City, which says a lot about it. It begins with a quotation from Long Day's Journey Into Night, which says more about it: "None of us can help the things life has done to us. They're done before you realize it, and once they're done they make you do other things until at last everything comes between you and what you'd like to be, and you've lost your true self forever." And it quotes Charles Lachenmeyer, the book's protagonist, over and over again, from a note he wrote to his son, the author: "There is never any reason to give up."

Nathaniel Lachenmeyer, the author, is the son of the late Charles Lachenmeyer, and, as a child, Nathaniel idealized his father. But in this book he presents him to us honestly, showing his father's serious flaws and tragic later life. Charles nevertheless, partly because of his son's idealization, seems larger than life in this volume. There are ironies upon ironies in this book One of the most prominent is the reaction of the young Nathaniel and his father to a psychotic homeless man in New York City.

Charles Lachenmeyer had a difficult childhood; his mother was simultaneously abandoning and controlling, and was a religious zealot. He was a brilliant student, earned a Ph.D. in sociology, wrote a few books, and rose to associate professor. But he also had poor social skills, had difficulty keeping his academic positions, and was a very heavy drinker. In early middle age he became very delusional and paranoid. This syndrome, diagnosed as paranoid schizophrenia, led to the loss of his marriage and his career, and he and his son became alienated as well. It is ironic that in graduate school, before his syndrome began, he did research on family dynamics in schizophrenia.

After Nathaniel Lachenmeyer learned that his father had died, he also learned that he had been homeless for a time, partly to escape the control of civil commitments in two states. The younger Lachenmeyer reconstructs his father's life in this book, and he does so with considerable success. While the explicit narrative concerns the father's' life with schizophrenia and alcoholism, there is a great deal about the son. How does a pre-teen make sense of his beloved father's delusional ravings about his equally beloved mother? How does he come to terms with not having sent his father money, when asked, or with seeing him, as an adult, but not introducing himself? There is guilt in this book, along with sadness and rage, and all of these are comprehensible to the reader. The author writes sparsely and evocatively.

In the eyes of most people, Charles Lachenmeyer lost everything. But in the view of his son, corroborated by many who knew the father, in spite of severe alcoholism and an extraordinary delusional system, he retained his sense of self, a sense of humor about his dealings with the court system, and a sense of indomitability in his efforts to find an academic post.

This book has many positive features, which I have stressed above. Negative features are minor and, for me, included wanting more information on some of the clinical points of the illness and especially its apparently major affective component, and more on the severity of the alcoholism. These are trivial in the context of the book.

I found this book both sad and inspiring - sad in terms of the life course and repeated humiliation of a protagonist I grew to admire, and inspiring for the example of Charles Lachenmeyer's indomitability in spite of all the humiliations, indignities, and terrible clinical course. One comes away from this book with the idea that the chronically mentally ill, many of them homeless, should not be trivialized and ignored as is too often the case in our society and among its healers.

I strongly recommend this excellent book.

Lloyd A. Wells is a child and adolescent psychiatrist at the Mayo Clinic in Minnesota. He has a particular interest in philosophical issues related to psychiatry and in the logic used in psychiatric discourse.

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